The 53-Year-old has been suffering from since a few weeks a rash on her legs, as she asks in an Israeli hospital for help. The skin hurts and looks like she would be covered with large mosquito bites.
The Posts are each several centimeters in size, make a note of the Doctors at the Sanz Medical center in Netanya. Irregularly, they cover the fronts of your shins and thighs. Over time, some of the spots suddenly disappeared, according to the patient. New were formed.
The Doctors start to ask for other complaints. Your patient has a fever? Sweats? Problems with digestion? Or Chest Pain? The woman denied everything, she was otherwise healthy. Drugs not taken, report the physician to Ami Schattner in the “British Journal of Case Reports”. So, the doctors start the physical examination.
Hepatitis, HIV, Herpes?
The rash, Erythema nodosum, or node, rose can have different causes. Often it is a result of an Overreaction of the immune system, triggered by a severe infection. First of all, the Doctors check whether the woman has been infected with streptococci. A tonsillitis the spherical bacteria may radiate to the skin. A swab in the pharynx, however, shows a negative result.
Streptococci often form chains
Also in the blood of the patient, the doctors can’t find anything. Neither against Herpes, Hepatitis, or HIV Antibodies circles through the body of the woman. Tests for more serious infections, such as tuberculosis, are also negative – actually positive.
However, the Doctors still have no idea what’s bothering your patient. You begin to examine your body piece by piece. Observe the ECG, as your heart muscle is working. Ask you to a gynaecological examination. You look at an ultrasound in the abdominal cavity. Looking at a eyes mirroring to changes in the retina. Send the urine to the lab.
And find: nothing.
The woman seems to be completely healthy, all of the usual causes of the rash are excluded at this time. It was only when the Doctors of the 53-Year-old also inject a contrast medium and CT to push, you will discover out of the ordinary.
The cats are to blame?
The spleen of the woman is enlarged, as well as the lymph nodes in the vicinity of the main artery. Also in the armpit, the doctors discover extremely swollen lymph nodes. The fabric seems to be so attacked, that the death of cells in an uncontrolled manner. The Doctors are alarmed.
The thickness of the lymph nodes indicates that the immune system is active – a sign of an infection. In addition, they are also an indicator of a cancer disease. Due to the proximity to the breast, the Doctors do a mammogram, cancer, not a trace. In the blood of the patient is also no substance to speak for a Tumor circles. So it is that an infection?
CT images of the upper body: The arrows point to swollen lymph nodes in the underarm area
The strongly swollen lymph nodes bring the Doctors finally, on the crucial idea: The 53-Year-old had told them that she feeds daily in the backyard with the cats. Did you get infected? Especially young cats often carry bacteria, which can Scratch or Bite, but rarely without an attack on the humans. So it would have to be the woman, you can’t remember a cat attack.
Many cat owners affected
The cats, even the bacteria usually cause no problems, just like most people. Nearly one in Ten carries antibodies as an indication of a past infection in his blood, especially cat owners. However, sometimes the body rebels. Then the so-called cat scratch disease.
Among the most common sign of swollen lymph nodes and fatigue, both symptoms of the patient. In addition, it is not, however, often also have a fever and pustules on the wound of which you suffer. Nevertheless, the doctors are confident. Around a fifth of those Affected, the disease is uncommon. This could also explain your skin rash.
The physicians test their patient and find. In the blood of the woman large amounts of antibody to swim against the cats-bacteria Bartonella henselae. In addition, a sample from a shrug-confirmed lymph nodes the suspicion that the death of cells. At least, that is typical for the infection.
In people with a healthy immune system, the disease heals often. Due to the week-long complaints, the Doctors treat their patient with antibiotics. After four days you can leave the hospital, her condition is slowly improving. Four weeks later, she has recovered completely, reports the physicians.
Need to make cat owners Worried about?
Derived from the case, around 1500 to 2000 people in the United States would have a year in Germany at the cat scratch disease, wrote the RKI in 2003 in a report. Will be detected the infection in this country, but only rarely.
For people with a healthy immune system, the disease is usually not a Problem. More dangerous is when the body is weakened and its own defences such as due to cancer treatment or an untreated HIV infection. Then, the bacteria can cause blood vessels to grow uncontrollably. The patient should be therefore, when handling cats gently.
A cat has scratched, advises the US health authority CDC, the wound with water and soap to wash out. Only if it is within one to three weeks, fever, lymph node swelling, or pustule will form at the wound, is, according to the experts, a visit to the doctor is necessary.